Skip to main content
×
×
Home

Recovery: an international perspective

  • Mike Slade (a1), Michaela Amering (a2) and Lindsay Oades (a3)
Summary

Aims – To review developments in recovery-focussed mental health services internationally. Methods – Two forms of ‘recovery’ which have been used in the literature are considered, and international examples of recovery-focussed initiatives reviews. A ‘litmus test’ for a recovery-focussed service is proposed. Results – ‘Clinical recovery’ has emerged from professional literature, focuses on sustained remission and restoration of functioning, is invariant across individuals, and has been used to establish rates of recovery. ‘Personal recovery’ has emerged from consumer narratives, focuses on living a satisfying, hopeful and contributing life even with limitations caused by the illness, varies across individuals, and the empirical evidence base relates to stages of change more than overall prevalence rates. Clinical and personal recovery are different. Two innovative, generalisable and empirically investigated examples are given of implementing a focus on personal recovery: the Collaborative Recovery Model in Australia, and Trialogues in German-speaking Europe. The role of medication is an indicator: services in which all service users are prescribed medication, in which the term ‘compliance’ is used, in which the reasoning bias is present of attributing improvement to medication and deterioration to the person, and in which contact with and discussion about the service user revolves around medication issues, are not personal recovery-focussed services. Conclusions – The term ‘Recovery’ has been used in different ways, so conceptual clarity is important. Developing a focus on personal recovery is more than a cosmetic change – it will entail fundamental shifts in the values of mental health services.

Declaration of Interest: None.

Copyright
Corresponding author
Address for correspondence: Dr. M. Slade, Health Service and Population Research Department Institute of Psychiatry, King's College London, Denmark Hill, London SE5 8AF, (United Kingdom). E-mail: m.slade@iop.kcl.ac.uk
References
Hide All
Alanen, Y.O. (1997). Schizophrenia. Its Origins and Need-Adapted Treatment. Karnac Books: London.
American Psychiatric Association (2005). Position Statement on the Use of the Concept of Recovery. American Psychiatric Association: Washington DC.
Amering, M. & Schmolke, M. (2007). Recovery. Das Ende der Unheilbarkeit. Psychiatrie-Verlag: Bonn.
Amering, M., Hofer, H. & Rath, I. (2002). The “First Vienna Trialogue” – experiences with a new form of communication between users, relatives and mental health professionals. In Family Interventions in Mental Illness: International Perspectives (ed. Lefley, H.P. and Johnson, D.L.). Praeger: Westport CT.
Andresen, R., Oades, L. & Caputi, P. (2003). The experience of recovery from schizophrenia: towards an empirically-validated stage model. Australian and New Zealand Journal of Psychiatry 37, 586594.
Andresen, R., Caputi, P. & Oades, L. (2006). The Stages of Recovery Instrument: Development of a measure of recovery from serious mental illness. Australian and New Zealand Journal of Psychiatry 40, 972980.
Anthony, W.A. (1993). Recovery from mental illness: the guiding vision of the mental health system in the 1990s. Innovations and Research 2, 1724.
Australian Health Ministers (2003). National Mental Health Plan 2003-2008. Australian Government: Canberra.
Bellack, A. (2006). Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophrenia Bulletin 32, 432442.
Bleuler, M. (1978). The Schizophrenic Disorders. Yale University Press: New Haven, CT.
Bock, T. & Priebe, S. (2005). Psychosis seminars: an unconventional approach. Psychiatric Services 56, 14411443.
British Psychological Society Division of Clinical Psychology (2000). Recent Advances in Understanding Mental Illness and Psychotic Experiences. British Psychological Society: Leicester.
Cabinet Office (2006). Reaching Out: An Action Plan on Social Inclusion. Cabinet Office: London.
Care Services Improvement Partnership, Royal College of Psychiatrists & Social Care Institute for Excellence (2007). A Common Purpose: Recovery in Future Mental Health Services. CSIP: Leeds.
Ciompi, L. & Hoffmann, H. (2004). Soteria Berne: an innovative milieu therapeutic approach to acute schizophrenia based on the concept of affect-logic. World Psychiatry 3, 140146.
Ciompi, L. & Muller, C. (1976). The Life-Course and Aging of Schizophrenics: a Long-Term Follow-up Study into Old Age. Springer: Berlin.
Clarke, D. (2003). Faith and hope. Australasian Psychiatry 11, 164168.
Cohen, P. & Cohen, J. (1984). The clinician's illusion. Archives of General Psychiatry 41, 11781182.
Coleman, R. (1999). Recovery – an Alien Concept. Hansell: Gloucester.
College of Occupational Therapists (2006). Recovering Ordinary Lives: The Strategy for Occupational Therapy in Mental Health Services 2007-2017. College of Occupational Therapists: London.
Copeland, M. & Mead, S. (2003). WRAP and Peer Support: A Guide to Individual, Group and Program Development. Peach Press: Dummerston, VT.
Crowe, T., Deane, F., Oades, L.G., Caputi, P. & Morland, K.G. (2006). Effectiveness of a collaborative recovery training program in Australia in promoting positive views about recovery. Psychiatric Services 57, 14971500.
Davidson, L. & Strauss, J. (1992). Sense of self in recovery from severe mental illness. British Journal of Medical Psychology 65, 131145.
Davidson, L., O'Connell, M., Tondora, J., Styron, T. & Kangas, K. (2006). The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services 57, 640645.
Davidson, L., Schmutte, T., Dinzeo, T. & Andres-Hyman, R. (2008). Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophrenia Bulletin 34, 58.
Deane, F., Crowe, T., King, R., Kavanagh, D. & Oades, L. (2006). Challenges in implementing evidence-based practice into mental health services. Australian Health Review 30, 305309.
Deegan, P. (1988). Recovery: the lived experience of rehabilitation. Psychosocial Rehabilitation Journal 11, 1119.
Deegan, P. (1990). Spirit breaking: When the helping professions hurt. Humanistic Psychology 18, 301313.
Department of Health (2001). The Journey to Recovery – The Government's Vision for Mental Health Care. Department of Health: London.
Department of Health (2006). From Values to Action: The Chief Nursing Officer's Review of Mental Health Nursing. HMSO: London.
De Sisto, M.J., Harding, C.M., McCormick, R.V., Ashikage, T. & Brooks, G. (1995). The Maine and Vermont three-decades studies of serious mental illness: II. Longitudinal course. British Journal of Psychiatry 167, 338342.
Drukker, M., Gunther, N. & van Os, J. (2007). Disentangling associations between poverty at various levels of aggregation and mental health. Epidemiologia e Psichiatria Sociale 16, 39.
Harding, C.M., Brooks, G., Ashikage, T., Strauss, J.S. & Brier, A. (1987). The Vermont longitudinal study of persons with severe mental illness II: long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry 144, 727735.
Harrison, G., Hopper, K., Craig, T., Laska, E., Siegel, C., Wanderling, J., Dube, K.C., Ganev, K., Giel, R., and der Heiden, W., Holmberg, S.K., Janca, A., Lee, P.W., Leon, C.A., Malhotra, S., Marsella, A.J., Nakane, Y., Sartorius, N., Shen, Y., Skoda, C., Thara, R., Tsirkin, S.J., Varma, V.K., Walsh, D. & Wiersma, D. (2001). Recovery from psychotic illness: a 15-and 25-year international follow-up study. British Journal of Psychiatry 178, 506517.
Healthcare Commission (2006). State of Healthcare 2006. Commission for Healthcare Audit and Inspection: London.
Henderson, C., Thornicroft, G. & Glover, G. (1998). Inequalities in mental health. British Journal of Psychiatry 173, 105109.
Hopper, K., Harrison, G., Janca, A. & Sartorius, N. (2007). Recovery From Schizophrenia: An International Perspective. A Report From the WHO Collaborative Project, the International Study of Schizophrenia. Oxford University Press: Oxford.
Huber, G., Gross, G. & Schuttler, R. (1975). A long-term follow-up study of schizophrenia: Psychiatric course and prognosis. Acta Psychiatrica Scandinavica 52, 4957.
Jacobson, N. (2001). Experiencing recovery: a dimensional analysis of consumers' recovery narratives. Psychiatric Rehabilitation Journal 24, 248256.
Jenkins, J.H., Strauss, M.E., Carpenter, E.A., Miller, D., Floersch, J. & Sajatovic, M. (2007). Subjective experience of recovery from schizophrenia-related disorders and atypical antipsychotics. International Journal of Social Psychiatry 51, 211227.
Knuf, A. (2004). Vom demoralisierenden Pessimismus zum vernünftigen Optimismus. Eine Annäherung an das Recovery-Konzept. Soziale Psychiatrie 1, 3841.
Kuhn, T. (1962). The Structure of Scientific Revolutions. Chicago University Press: Chicago.
Lapsley, H., Nikora, L.W. & Black, R. (2002). Kia Mauri Tau! Narratives of Recovery from Disabling Mental Health Problems. Mental Health Commission: Wellington.
Libermann, R.P. & Kopelowicz, A. (2002). Recovery from schizophrenia: a challenge for the 21st Century. International Review of Psychiatry 14, 242255.
Libermann, R.P. & Kopelowicz, A. (2005). Recovery from schizophrenia: a concept in search of research. Psychiatric Services 56, 735742.
Marneros, A., Deister, A., Rohde, A., Steinmeyer, E.M. & Junemann, H. (1989). Long-term outcome of schizoaffective and schizophrenic disorders, a comparative study, I: Definitions, methods, psychopathological and social outcome. European Archives of Psychiatry and Clinical Neuroscience 238, 118125.
Marshall, S.L., Crowe, T., Oades, L., Deane, F., & Kavanagh, D. (2007). A review of consumer involvement in evaluations of case management: consistency with a recovery paradigm. Psychiatric Services 58,396401.
Masterson, S. & Owen, S. (2008). Mental health service user's social and individual empowerment: Using theories of power to elucidate far-reaching strategies. Journal of Mental Health 15, 1934.
McIntosh, Z. (2005). From Goldfish Bowl to Ocean: Personal Accounts of Mental Illness and Beyond. Chipmunkapublishing: London.
McNaught, M., Caputi, P., Oades, L. & Deane, F. (2007). Testing the validity of the Recovery Assessment Scale using an Australian sample. Australian and New Zealand Journal of Psychiatry 41,450457.
Mental Health Commission (1998). Blueprint for Mental Health Services in New Zealand. Mental Health Commission: Wellington.
Mental Health Commission (2005). A Vision for a Recovery Model in Irish Mental Health Services. Mental Health Commission: Dublin.
National Institute for Mental Health in England (2004). Emerging Best Practices in Mental Health recovery. NIMHE: London.
New Freedom Commission on Mental Health (2005). Achieving the Promise: Transforming Mental Health Care in America. U.S. Department of Health and Human Services: Rockville, MD.
Oades, L., Deane, F., Crowe, T., Lambert, W.G., Kavanagh, D. & Lloyd, C. (2005). Collaborative recovery: an integrative model for working with individuals who experience chronic and recurring mental illness. Australasian Psychiatry 13, 279284.
Office of the Deputy Prime Minister (2004). Mental Health and Social Exclusion. Social Exclusion Unit: London.
Ogawa, K., Miya, M., Watarai, A., Nakazawa, M., Yuasa, S. & Utena, H. (1987). A long-term follow-up study of schizophrenia in Japan, with special reference to the course of social adjustment. British Journal of Psychiatry 151, 758765.
O'Hagan, M. (2004). Recovery in New Zealand: Lessons from Australia? Australian e-Journal for the Advancement of Mental Health 3, 13. Retrieved March 25, 2008, from www.auseinet.com/journal/voBissl/ohaganedi torial.pdf.
Oyebode, F. (2004). Invited Commentary on: The rediscovery of recovery. Advances in Psychiatric Treatment 10, 4849.
Priebe, S. & Turner, T. (2003). Reinstitutionalisation in mental health care. British Medical Journal 326, 175176.
Ralph, R.O. (2000). Recovery. Psychiatric Rehabilitation Skills 4, 480517.
Raymont, V., Bingley, W., Buchanan, A., David, A.S., Hayward, P., Wessely, S. & Hotopf, M. (2004). Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet 364, 14211427.
Rickwood, D. (2004). Recovery in Australia: Slowly but surely. Australian e-journal for the Advancement of Mental Health 3. Retrieved March 25, 2008, from www.auseinet.com/journal/voBissl/ohaganeditorial.pdf.
Ridgway, P. (2001). Restorying psychiatric disability: Learning from first person narratives. Psychiatric Rehabilitation Journal 24, 335343.
Rosen, A. (2007). Return from the vanishing point: a clinician's perspective on art and mental illness, and particularly schizophrenia. Epidemiologia e Psichiatria Sociale 16, 126132.
Rosen, A., Hadzi-Pavlovic, D. & Parker, G. (1989). The life skills profile: a measure assessing function and disability in schizophrenia. Schizophrenia Bulletin 15, 325337.
Ruggeri, M. & Tansella, M. (2007). Achieving a better knowledge on the causes and early course of psychoses: a profitable investment for the future? Epidemiologia e Psichiatria Sociale 16, 97101.
Schrank, B. & Slade, M. (2007). Recovery in Psychiatry. Psychiatric Bulletin 31, 321325.
Scottish Recovery Network (2006). Journeys of Recover Stories of Hope and Recovery from Long Term Mental Health Problems. Scottish Recovery Network: Glasgow.
Seeker, J., Membrey, H., Grove, B., & Seebohm, P. (2002). Recovering from illness or recovering your life? Implications of clinical versus social models of recovery from mental health problems for employment support services. Disability & Society 17, 403418.
Sibitz, I., Swoboda, H., Schrank, B., Priebe, S. & Amering, M. (2007). Mental Health Service User Involvement in Therapeutic and Service Delivery Decisions: Professional Service Staff Appear Optimistic. Psychiatrische Praxis, Nov [epub ahead of print].
Slade, M. & Hayward, M. (2007). Recovery, psychosis and psychiatry: research is better than rhetoric. Ada Psychiatrica Scandinavica 116, 8183.
Spaniol, L., Wewiorski, N., Gagne, C. & Anthony, W. (2002). The process of recovery from schizophrenia. International Review of Psychiatry 14, 327336.
Stastny, P. & Lehmann, P. (Eds.) (2007). Alternatives Beyond Psychiatry. Peter Lehmann Publishing: Shrewsbury.
Steinert, T. (2007). Perspektivenwechsel. Psychiatrische Praxis 43, 362.
Substance Abuse and Mental Health Services Administration (2005). National Consensus Conference on Mental Health Recovery and Systems Transformation. Department of Health and Human Services: Rockville, MD.
Thornicroft, G. (2005). Shunned: Discrimination against People with Mental Illness. Oxford University Press: Oxford.
Tondora, J. & Davidson, L. (2006). Practice Guidelines for Recovery-Oriented Behavioral Health Care. Connecticut Department of Mental Health and Addiction Services: Connecticut.
Tsuang, M.T., Woolson, R.F. & Fleming, J. (1979). Long-term outcome of major psychosis. Archives of General Psychiatry 36, 12951301.
Warner, R. (2007). Review of “Recovery From Schizophrenia: An International Perspective. A Report From the WHO Collaborative Project, the International Study of Schizophrenia”. American Journal of Psychiatry 164, 14441445.
Wing, J.K., Beevor, A.S., Curtis, R.H., Park, S.B., Hadden, S. & Burns, A. (1998). Health of the Nation Outcome Scales (HoNOS). Research and Development. British Journal of Psychiatry 111., 1118.
World Health Organization (2005). Mental Health Declaration for Europe: Facing the Challenges, Building Solutions. Retrieved March 25, 2008, from http://www.euro.who.int/document/mnh/ edoc06.pdf.
Wynaden, D & Orb, A (2005). Impact of patient confidentiality on carers of people who have a mental disorder. International Journal of Mental Health Nursing 14, 166171.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology and Psychiatric Sciences
  • ISSN: 2045-7960
  • EISSN: 2045-7979
  • URL: /core/journals/epidemiology-and-psychiatric-sciences
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed